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General order, 
Conf Pam #725 

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SURGEON GENERAL'S OFFICE, 

Raleigh, December 25, 1864. 
General Order,] 

No. J 

I. The following instructions are published lor the guidance of 
Medical Officers in the service of this State. 

II. In their examinations of all applicants, they must exorcise a 
sound discretion, remembering the necessities of their country, and 
excusing no man through fear, favor or' affection. 

III. They should remember, that, as h general rule, those who 
are capable of discharging the active dutios incident to the various 
occupations of life, are able to perform the duties of soldiers in the 
field. 

IV. In every instance they should make a tjoioii^h examina- 
tion of the applicant, seeking ior all the physical and rational indi- 
cations of the alleged disability, testing the accuracy of the pa- 
tient's statements by their own observations, and the testimony? of 
reliable physicians, examining into the previous history of the case 
and guarding against deceit and imposition as far as practicable. 

V. The following are some of the grounds not deemed sufficient 
and satisfactory for exemption — though there are many others wliich 
must be left to the judgment of those conducting the examination : 

Dea/nesi. — This is no valid reason for exemption, unless exces- 
sive or complete. The fact of its existence must ai»o be established 
by the oath of some respectable physician, who has had an opportu- 
nity of determining the matter for himself 

Myopia. — This is -not a ground for exemption under ordinary cir- 
cumstances. In extraordinary cases the applicant may be excused 
at ihe discretion of the Surgeon. 

Defect of one eye. — Neither opacity of the cornea, nor even tire 
entire loss of one eye — unless the other is seriously implicated — is a 
proper ground for exemption. 

Idioci/. — If the applicant is unable to establish the fact of his ina- 
bility to discharge the ordinary duties of life, he should not be ex- 
cused CD this account, 
j j Diseaset of the Heart. — Functional diseases of the Heart are not 
valid grounds for exemption. Orginic diseases must be accurately 
'^ andcrstood and diagnosed before they can be regarded as disqualify, 
ing causes. 

Aneurisms. — If small vessels only ar« inTolred, the applicaat 
should not b€ excused. 



Varicocele. — This is not a proper ground for exemption, unless 
excessive. 

Varicose Veins of the Extremitioi — Tliir, affection is not'a legiti- 
mate ground for exemption sis a general rule. In extreme cases 
the applicant mai/ be^xcused. 

Rheumatism. — Muscular iheuniatism is not a proper ground for 
exemption. Articular rhcuinatism cannot be regarded as a valid 
excuse, unless some serious flcloniiity or loss of motion has resulted 
from it, provided the gene .a! health of the applicaut be notseii- 
ously impaired. 

Ilimorrhoids. — These do not constitute a proper ground for ex- 
emptiuD, unless the case is an ex' mo, one. 

Hernia. — Single reducible hen; .t .s not a valid cause for exemp- 
tion. 

De/ormiti/. — Unless the functions of the member are materially 
intertered with, deforinity is not a proper ground upon which to 
grant the certificate, li' one leg be so shortened or otherwise de- 
formed, so that the habitual use of a crutch or stick is nccesiilattd ; 
if a member is wasted, paralyzed, anchyloscd, ttc, or if man; than 
two fingers have been lost from either hand, the applicant should 
be excused. The loss of an entire thumb is a serious cncunistauce. 

General Dtbdity. — It must be remembered in this connexion tliat 
a so-called high standard of health does not best enable the soldi.-r 
•to encounter the exposure, fatigue and hardship incident to his call- 
ing. There seems to be associated with the inferior grades of health 
less predisposition to disease, especially of an iiill imniatory character^ 
These facts should serve as guides to the Surgeon in determining 
how far, what is known as general di^biVti/, should excuse a man 
from military duty. If there be no serious organic disease associated 
with it, and but little loss of strength, &e., the applicant should not 
be excused. The best test of his ability to withstand the trials of a 
soldier's life, is to be found in the moJe, &c., wherein his usual oc- 
cupation is performed. 

VI. A definite statement should always be made as to the locality, 
extent and nature of the alleged malady, the length of time it has 
exi^tcd, and the probable period of its duration. 

VII. In all maladies ]>ortaining to the Heart and Lungs, the moat 
accurate ^>//^*'>a/ explorations should be resorted to, for the purpose 
of ascertaining difmitdy the jtrecisc locality and the exact nature of 
the diseasCj together with the extent to which it has progressed. 

By order of Governor V.vxce: 

EDWARD WARREX, 
Surgeon CcncraL_ N. C. 



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